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Travelling Allowance Form

1. This is a travel allowance bill form from the Indian Institute of Technology Roorkee for reimbursement of travel expenses. 2. It collects information about the claimant such as name, designation, address, and details of the journey including dates of travel, modes of transportation, and fares. 3. It also collects details about daily allowance claims and local transportation costs to calculate the total amount to be reimbursed.

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shivam choudhary
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2K views1 page

Travelling Allowance Form

1. This is a travel allowance bill form from the Indian Institute of Technology Roorkee for reimbursement of travel expenses. 2. It collects information about the claimant such as name, designation, address, and details of the journey including dates of travel, modes of transportation, and fares. 3. It also collects details about daily allowance claims and local transportation costs to calculate the total amount to be reimbursed.

Uploaded by

shivam choudhary
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

INDIAN INSTITUTE OF TECHNOLOGY ROORKEE

Travelling Allowance Bill


Name (in Block letters):…………………………………………………. Pay: ……………………………………. D.A.:……………………………………
Designation:………………………………………………………………….. Total Rs.:……………………………………………………………………………
Address:………………………………………………………...……………… (Employment No. ……………………..)
Particulars of Journey Journey by Rail/Road/Air Details of D.A. Local Journey
Departure Arrival Fare
Station Date Time Station Date Time Mode of Rs./P. Distance Amount Purpose of Journey
Journey Class Date Rate Amount Rs. From To in km Rs.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

18. Remarks if any

1. I certify that I have not drawn TA & DA in this connection For Office use only
from any other source. The payment is actually due and is 1. Sum of totals in column: Rs…………………………………
being charged for the first time. 9,12 and 16 Pay Rs…………………………………………………………………………………………….
2. I certify that I have actually travelled in the class for which I
am charging Railway / Air fare as paid by me. 2. Advance, if any: Rs………………………………… Rs. (in words)………………………………………………………………………………….
3. I certify that I did not avail of free boarding and lodging
facilities at the out station. 3. Net claim Rs………………………………… Debit to…………………………………………………………………………………………
4. Onward journey will be performed as claimed.
5. Certified that I have traveled by Taxi Revenue
No…………………………………… having valid taxi papers as
Stamp
specified in para 7 of Notification No. IITR/Gen/A-
207(Taxi)2006/1590 dated 29th November 2006.

Signature of Claimant COUNTERSIGNED Supdt. (Bills) D.R.(A&A)/ A.R.(A&A) Dean(F&P)

Claim Verified

Signature of claimant Signature of verifying Officer Controlling Officer

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